Wednesday, August 11, 2010

Help!

All right, this is a post that is 100% baby. I am in need of some help. I know a lot of my blog readers aren't parents, but many still know a lot about babies, and others have had lots of babies and might be able to help me out. Feel free to skip if you're not interested.

Here's the problem. Since Marko was about 12 weeks old, he has been very difficult to get to nurse. When he's not hungry, it's not an issue -- he simply turns his head away and I put him down again. But when he is hungry, it's a huge issue. He throws himself backward and screams, seeming to be either in pain or very angry. I know he's hungry because it's often been quite some time since he's eaten, and he also gives some strong cues like biting on my shirt or sucking on my finger. And yet, he won't nurse!

I've mentioned before that he used to nurse with a plastic shield, which was a huge pain. At 10 weeks he weaned himself off of it and nursed just fine ... for two weeks. Then the arching and screaming started cropping up. At first it was just when he was overtired; now it's pretty close to always.

It's not that he'd prefer a bottle, because the first bottle of his life was yesterday. I'd offered them before, but he was never interested and I didn't push it. This time, after a lot of screaming and misery, I offered a bottle of expressed milk and he drank it right down before falling asleep.

Things that help: nursing him every 45 minutes; starting him off on a pacifier or finger and switching; trying to get him to self-attach (sometimes); nursing lying down; nursing the moment he wakes up from a nap. Things that don't help: waiting for him to get hungrier. He will go for 3-4 hours without nursing before screaming himself to sleep (and then I nurse him on awakening). Repeat: it is NOT that he is not hungry!

So I have a few ideas of what it could be, based on some research I've done on nursing strikes and nursing aversion.

Thrush: a yeast overgrowth in baby's mouth. Why he might have it: Thrush can cause nursing to be painful, so a baby will refuse to nurse. Why he might not have it: There are no other symptoms -- no white patches in the mouth, no bad diaper rash, no apparent yeast on me, etc.

Silent reflux: acid gurgling up in baby's throat and hurting him. Why he might have it: Babies with reflux occasionally come to dislike nursing because they know it will make their throat hurt later. He has some symptoms: occasionally a gurgly noise in the throat, frequent hiccups, when I lay him down on his back he rolls onto his side and arches into a banana shape, frequent nursing helps. Why he might not have it: Usually reflux appears very early on, not at 12 weeks. He's not a big spit-upper. He doesn't cry when laid on his back or when his throat makes that gurgly noise. He's a good sleeper.

Teething: teething babies often refuse to nurse because the sucking motion can hurt their gums. Why he might have it: he's drooling, chomping on everything, and these past couple of days he's been very fussy and soothed by a cold pacifier. Why he might not have it: he's been doing this for over a month, and no sign of a tooth. Besides, he likes to suck just fine -- in fact he sucks on everything -- he just doesn't like to nurse.

A behavioral issue: It's possible that using that shield has confused him somehow, so that he doesn't know how to latch well and gets confused about it when he's upset or tired. He also seems to have developed a preference for pacifiers, and doesn't like the real thing as much. I have never yelled at him while nursing or any such thing. The funny thing is, originally he just minded nursing in one single position, and if I switched things up a bit he wouldn't mind. But as he's caught onto my various "tricks," suddenly he gets suspicious and will cry if he's brought even remotely near a breast. It's the strangest thing.

Does ANYONE have anything that might help me? I'm planning to take him to the doctor and see what they can tell me, but he appears healthy other than this one thing, so I'm not sure they will be able to help. I just would like to get my little boy to like nursing again.

9 comments:

Fidelio said...

Thrush isn't too common, Sheila, or I'd say that sounded likely. When you fed him the expressed milk, were you holding him more upright than usual? I wonder if it isn't a combination of reflux and the "behavior" thing. While reflux appears early and usually goes away, V did a reflux/MASSIVE spitting up thing for four weeks, then not again until he was four months, then not again until he was eight months. It comes and goes with him. I wonder if Mark is afraid all the time of the reflux part, even though it might not be a continuous problem? Hmmm...mysterious.

Allison said...

Have you gone to a lactation consultant versus the doctor? Or La Leche League? I have a feeling they'd be better prepared to help you than a doctor for an otherwise healthy baby.

I've never had a baby, but read a lot about it. I wonder if it has to do with when he's over-hungry? As you said, nursing him more often helps. So perhaps if you kept on a schedule for a while he might stop with the screaming and refusing to nurse?

Sheila said...

Huh, I never heard of reflux coming and going! Thanks, Fidelio.

I held the bottle in a normal nursing position, so that wasn't it. However, if it were intermittent reflux, it would make sense because he didn't have the association of pain with the bottle.

I would see an LC, but I can't afford it. :P I plan to go to an LLL meeting next week though. The frequent nursing is helping, but not entirely ... sometimes he will still be upset no matter when I offer, particularly if he's overtired (like he was today - would not nap for some reason).

Beth said...

I exclusively nursed two babies for 6 months, then continued with one to 17 months and the other to 15 months. The behavior you described happened to me often, especially at the beginning of each nursing relationship.

An LC explained it to me this way: especially after not nursing for a while, my milk "letdown" at the time of nursing was so powerful that the voluminous spray of milk all at once was startling to the baby. She coached me to pump a small amount to induce the milk flow, then try to latch. This works in a two-fold way: (a) the let down isn't so forceful and (b) the nipple becomes coated with milk, which helps to entice the feeding.

Also, in my experience (and only mine....just sharing FYI), in the case of an otherwise healthy baby, a pediatrician may be quick to suggest introducing formula; doctors love the quick fix, especially when they have free samples to hand out. :::sigh:::

Whatever happens, best of luck to you & Marko!

Beth said...

I forgot to add....herer is some more infor on overactive letdown:
http://en.wikipedia.org/wiki/Overactive_let-down

http://www.llli.org/llleaderweb/LV/LVSepOct95p71.html

Sheila said...

Huh, that might be so. Sometimes he kind of chokes and splutters (which would explain why the shield helped). However he usually pulls off before the letdown, which often takes a long time to happen ... perhaps in that case he is impatient for it? Pumping would help for that too, though.

New update: after a whole lot of screaming, a restless nap, and more refusal to nurse, I used the old plastic shield. Usually it doesn't work, but this time it did. At any rate it's nice to have the option in my toolbox ... I hate the dang thing but it's better than no nursing.

Fidelio said...

You know, I'm dumb. The early spitty baby days were also overactive letdown days, also at 4 months. I should have mentioned that. I was literally drowning the little guy!

That doesn't seem to make as much sense if it takes a long time for letdown to even happen, though. Sounds like a LLL meeting might be the place to go!

Sheila said...

Well, I don't know. It might be that the letdown is slow, but then a whammy when it does happen. However, I think an UNDER-active letdown might be more the problem.

However, I've started using the shield again for those occasions when he gets screamy, and it's really been helping. He still seems upset, but I'm able to stick the shield into his mouth. Once he realizes it's there, he calms right down and nurses. I'm still not sure what the problem is, but this is curing the symptom anyway.

I also wonder if I've not had as much milk lately (due to all the nursing issues ... it's a self-proliferating problem). So when he does want to nurse, there's not much there, and he gets all fussy. Today I seem to have more than I have all week... and the diaper output is improved too.

Right now my theory is that his tummy hurts when he's hungry. Maybe it gets too acidic when he hasn't had anything to eat in awhile. So he gets really grouchy and upset, and it SEEMS like nursing will hurt, even though once he gets latched on, he finds it doesn't? I don't know; I'm kind of grasping at straws here. It may just be that, since he learned to latch on later in life, he forgets how when he's upset (e.g. overtired or very hungry). Today he's been happy as a clam and nursing very frequently with no problems. *shrug*

WorkingOnWorthy said...

I know this is too late to help with your son. But in case any future litle ones have reflux, here is some information about how it presented "silently" for my son.

http://workingonworthy.blogspot.com/2012/07/silent-reflux.html

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